Practice Pulse QUESTION: I have a form requesting medical information
regarding my patient from a doctor of chiropractic who is also certified by the American Veterinary Chiropractic Association to adjust animals. The form states that I am referring this patient to her for treatment. How do I respond and is she legally able to treat this dog? A: A chiropractor cannot adjust an animal under their license. If a chiropractor associates with a veterinarian, the chiropractor can treat an animal under the veterinarian’s authority. It is a properly delegable task that can be done under responsible supervision of the veterinarian. Issues of responsibility and risk must be handled between the parties. The veterinarian must ensure they or the chiropractor has the proper insurance to handle the amount of risk that may be associated with treatment. There is a large disparity of risk if the treatment is for a million-dollar racehorse as opposed to a companion animal. The veterinarian’s license is “on the line” if they delegate to a person that is not qualified by licensure, training or experience. We've reproduced the Rule in the Florida Administrative Code below, which applies in this case. 61G18-19.002 Complementary or Alternative Veterinary Medicine. (1) Definition – Complementary, alternative and integrative therapies means a heterogenous group of preventive, diagnostic and therapeutic philosophies and practices, which at the time they are performed may differ from current scientific knowledge, or whose theoretical basis and techniques may diverge from veterinary medicine routinely taught in accredited veterinary medical colleges, or both. These therapies include, but are not limited to, veterinary acupuncture, acutherapy and acupressure, veterinary homeopathy, veterinary manual or manipulative therapy (i.e., therapies based on techniques practiced in osteopathy, chiropractic medicine, or physical medicine and therapy); veterinary nutraceutical therapy and veterinary physiotherapy. (2) Communication of treatment alternatives – A licensed veterinarian who offers to provide a patient with complementary or alternative health care treatment must inform the owner of the patient of the nature of the treatment and must explain the benefits and risks associated with the treatment to the extent necessary for the owner to make an informed and prudent decision regarding such treatment option. In compliance with this subsection: (a) The licensed veterinarian must inform the owner of his or her education, experience and credentials in relation to veterinary complementary or alternative health care treatment option. (b) The licensed veterinarian may, in his or her discretion, communicate the information orally or in written form directly to the owner or to the owner’s legal representative.
28 | FVMA ADVOCATE
(c) The licensed veterinarian may, in his or her discretion and without restriction, recommend any mode of treatment that is, in his or her judgment, in the best interests of the patient, including complementary or alternative health care treatments, in accordance with the provisions of his or her license. (3) Records – Every licensed veterinarian providing a patient with a complementary or alternative health care treatment must indicate in the patient’s record the method by which the requirements of subsection (2) were met. (4) Effect – This section does not modify or change the scope of practice of any licensed veterinarian, nor does it alter in any way the provisions of Chapter 474, F.S., which require licensees to practice within standards of care, and which prohibit fraud and exploitation of clients.
QUESTION: I am a practicing veterinarian in Vero Beach, Florida, and my pharmacy has just told me that, according to a law passed in January of this year, all prescriptions after July 1st are to be electronic only. They will no longer accept written scripts, emails or faxes. Do you have a recommendation on a company that we should use? A: This law does not apply to veterinarians. It only applies to “health
care practitioners” as defined in F.S. 456 (DOH). Veterinarians are governed under F.S. 474 which is not included in the 456.001 Definitions (4) F.S.
QUESTION: I'm currently a licensed veterinarian in Florida and recently spoke with another vet who claimed that in the state of Florida the VCPR is specific to the veterinarian and not to the clinic. That is to say, for example, if a veterinarian has not personally examined a patient, but the patient has been seen regularly and within the last 12 months by another veterinarian employed at the same clinic, it would be unlawful for the veterinarian who has not seen the patient to authorize prescription refills or prescribe new medications. Is this correct? A: The VCPR is with the veterinarian, not with the clinic. Nevertheless,
a VCPR can be established if the veterinarian has sufficient knowledge of the animal to initiate at least a general or preliminary diagnosis of the medical condition of the animal, which means that the veterinarian is personally acquainted with the keeping and caring of the animal and has recently seen the animal or has made medically appropriate and timely visits to the premises where the animal is kept, and • Is available or provides follow-up care and treatment in the case of adverse reactions or failure of the therapy regimen. • Maintains records documenting patient visits, diagnosis, treatment and other relevant information required under this chapter.
